AccountId: 011433970860
ContactId: 50cff6e3-9b1d-47da-9593-8080b64bcaa8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 504519 ms
Total Talk Time (AGENT): 309707 ms
Total Talk Time (CUSTOMER): 183192 ms
Interruptions: 3
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/50cff6e3-9b1d-47da-9593-8080b64bcaa8_20250523T17:04_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yeah, my name is [PII]. I'm calling from Doctor [PII]'s office. We have a mutual patient and um, I would like to verify insurance please.
[AGENT][POSITIVE] OK, I'm so sorry. What was your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII] thank you and you're needing to check eligibility or and or benefits or both?
[CUSTOMER][POSITIVE] Cover correct.
[CUSTOMER][NEUTRAL] Uh, eligibility.
[AGENT][POSITIVE] Yes, sir. I can help you, [PII].
[CUSTOMER][NEUTRAL] Yeah, because he's here to see one of our do mhm.
[AGENT][NEUTRAL] OK, I can help you and what is the numbers, I'm sorry, first off, what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and what is the member's policy number, please?
[CUSTOMER][NEUTRAL] Um, I, I have a D 41203489.
[AGENT][NEUTRAL] OK, now, thank you, but praying, that is not an American public life or APL policy number. That is a 90 degree benefit number. Does he also have a policy with APL or were you trying to actually reach 90 degree benefits?
[CUSTOMER][NEUTRAL] OK, let me
[CUSTOMER][NEUTRAL] Investment
[CUSTOMER][NEUTRAL] No, no, so we're trying to because we're primary care.
[AGENT][NEUTRAL] Do you have the full social security number for the subscriber?
[CUSTOMER][POSITIVE] And this one is the benefit.
[CUSTOMER][NEUTRAL] Um, I don't, can I put him on the phone to give you that?
[AGENT][NEUTRAL] Uh yes, sir, you can.
[CUSTOMER][NEUTRAL] All right mhm.
[CUSTOMER][NEUTRAL] So I have
[CUSTOMER][NEUTRAL] Security and maybe something else.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hi, this is [PII] with APL. Who, who am I speaking with, please?
[CUSTOMER][NEUTRAL] This is [PII].
[AGENT][NEUTRAL] OK, and [PII], um, he was giving me a number that is not an APL policy number. He said that he was trying to verify your eligibility on your policy. Now that the number that he was giving me is a 90 degree benefit number. Do you know if you also have coverage with APL?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] And it's getting worse.
[CUSTOMER][NEUTRAL] Yeah, those are all the numbers are in front of the can I see that?
[CUSTOMER][NEUTRAL] Yeah, those are the only numbers are on the card.
[AGENT][NEUTRAL] OK, what is your full social so that I can see if you have a policy with us before I transfer your provider?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me just say real loud if I'm looking at here um [PII].
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] [PII]. Was that the last four numbers?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Or last name?
[CUSTOMER][NEUTRAL] When did she have to stop them?
[AGENT][NEUTRAL] OK, so you do also have a policy with APL Nicholas, so do you, can you take.
[CUSTOMER][NEUTRAL] I know.
[AGENT][NEUTRAL] OK, so, but the number he gave me is not for APL so let me verify your information that we have on file for you and then I can explain how you can get the correct information so in the future you'll have it for our coverage.
[AGENT][NEUTRAL] So first off, if you'll please verify.
[CUSTOMER][NEUTRAL] OK, so, so basically the the.
[CUSTOMER][NEGATIVE] So basically the cards I have are null and void.
[AGENT][NEUTRAL] No, I'm not saying that. That may just be for your ninety-degree benefit coverage.
[AGENT][NEUTRAL] And if it says anything, does it say things on there about vision or anything else? Cause if it was our ID card, it would say APL on there.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Yeah, it says APL on here.
[AGENT][NEUTRAL] OK, so there should be a policy certificate number.
[CUSTOMER][NEUTRAL] Yeah, 0302573599.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, I asked him for that and he said that he, he had the, he gave me the D number.
[CUSTOMER][NEUTRAL] 7
[AGENT][NEUTRAL] So you have the right card. So I'll be yeah.
[CUSTOMER][NEUTRAL] No, no, the number the the the.
[CUSTOMER][NEUTRAL] Yeah, uh, alright, so the policy certificate number if you need it is 022573599.
[AGENT][NEUTRAL] No, sir. I, that's a.
[AGENT][NEUTRAL] Yeah, so that's OK, [PII]. I found it with your social, but I had asked him for that number initially and he could not give me that number, so.
[CUSTOMER][NEUTRAL] OK, OK
[CUSTOMER][NEUTRAL] Oh, OK, alright, sorry.
[AGENT][POSITIVE] Yeah, but that's fine. I'll be happy to speak back to the provider.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Wait, uh, so you need to talk to him now?
[AGENT][NEUTRAL] Well, I can go ahead and verify your informa. Let's verify your information since you are on the phone with me. What is your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and your home mailing address?
[CUSTOMER][NEUTRAL] I'm [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, thank you. The phone number that what is the phone number that we would have on file for you?
[CUSTOMER][NEUTRAL] [PII] Jesus for my number.
[AGENT][NEUTRAL] I'm sorry, what's the, what are the last four numbers of your phone number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so that is not what is on file for you. Let, let's go and verify your email and we'll come back.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That is what is on file for you. So is it 57 or 67?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 57
[AGENT][NEUTRAL] OK, thank you. And then your email address please?
[CUSTOMER][NEUTRAL] My last name [PII].
[AGENT][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK thank you [PII] for verifying your information and then before he gets back on the phone, have you ever set up your profile in the APL online service center portal so you can have access to your information? OK, good deal. Alright, well you have the correct information. He just, I guess overlooked that number so thank you again. Have a great weekend.
[CUSTOMER][NEUTRAL] I believe I did, yeah.
[CUSTOMER][NEUTRAL] I think so.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] [PII]. OK, so, yes, you had given me the incorrect number. I had asked for the policy number and you gave me a member ID. I was looking for the policy certificate number.
[CUSTOMER][NEUTRAL] Hi, go ahead, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Mhm.
[AGENT][NEUTRAL] OK, so any information that I provide for you is a verification of benefits and not a guarantee of payment. Um, this policy, this is a limited benefit plan. It is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Alright, um
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, sir. And for outpatients, um, for visits for an office visits, the maximum benefit per visit on this plan is $75 and a maximum of 5 visits per calendar year per covered person.
[CUSTOMER][NEUTRAL] OK, yeah, no, that's fine because he's here, the gentleman is here for a physical.
[CUSTOMER][NEUTRAL] Let me see [PII] [PII], correct?
[AGENT][NEUTRAL] That is correct. And this is not for sickness, this is for a wellness exam?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] So the maximum wellness exam and our test benefit is also $75.
[AGENT][NEUTRAL] And there is a maximum benefit for a diagnostic testing and a wellness exam and or a test benefit per calendar year of $250.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, no problem. One more thing and then we're all done. What's your name, dear?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Again, my name is [PII].
[AGENT][NEUTRAL] And if you need a call reference number you would use my name along with today's date.
[AGENT][NEUTRAL] And then also Preme if you all end up filing a claim with us for this number once the claim has been processed, we do have a portal in which you should be able to check the claim status and the website for that is located at [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Got it. I appreciate all your help. All right, we're all good.
[AGENT][POSITIVE] All right. Well, you're very welcome. Is there anything else? OK, well, thank you again for calling APL and I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] Uh, no, we're good.
[CUSTOMER][POSITIVE] You too take care bye bye mhm.
[AGENT][POSITIVE] Alright, you too. Thank you. Bye bye.
[CUSTOMER][POSITIVE] Thanks bye bye.